First, the apology.

Several of you couldn't get into sidebar session on May 26 on time because of a stale Zoom link. You showed up. The link didn't work. That's on me — not on you.

I've fixed it. Every future session will have a verified link before it goes out. If you're ever in doubt, reply directly to the email and I'll get you in. It won't happen again.

Now — to the people who did make it: thank you. Today's session ran long, and nobody left. That's the room I want.

Here's what we covered.

The nth job framework.

We had a subscriber on the line, epi/biostats from Hopkins, clinical data science background, looking to break into pharma for the first time.

My first question wasn't "what job are you applying for?" It was: what do you want to be doing in 10 years?

That order matters.

The first role doesn't matter as much as the trajectory you're building toward. When you're clear on the nth job, the first step becomes a lot easier to evaluate. Use LinkedIn. Find 10–15 people who share your exact background. Look at where they went. That's your map.

The pharma market is tight right now — 6 months has become 9 to 12 for most candidates. MFN, IRA, hiring freezes, portfolio cuts. Not trying to scare anyone. Just recalibrate the timeline. If pharma feels closed right now, consulting and service organizations are legitimate stepping stones — not consolation prizes. Build the relationship, build the publication record, and when the door opens, you'll be ready.

PhD vs. Master's — the honest take.

An attendee asked what most of you are probably wondering: is a PhD actually necessary to be competitive in HEOR right now?

Short answer: for entry-level technical roles, yes — in today's market.

Not because the methods demand it. Because there is an overflow of industry-experienced PhDs in the market right now, and some hiring managers filter accordingly. A PhD signals that you finished something hard, independently, over multiple years. That's a proxy for resilience. It's a de-risking signal in a hiring manager's head.

Does it matter after 5–7 years of experience? Not really. Nobody's asking me anymore. But if you're starting out, it's worth understanding what the signal means to the decision-maker on the other side of the table.

Think of it like HTA. What are the value drivers the payer is weighing? The PhD is one of them — early.

You + AI > AI alone.

We got into this one hard, and I want to be direct about where I stand.

AI is not coming for your job. It's coming for the version of you that refuses to touch it.

Here's the shift I've already seen: a competitive intelligence project that used to take a vendor 2 weeks and $25,000 now takes me 2 hours and a fraction of that. That's not theoretical. That's Tuesday.

For medical writers specifically — your value is no longer in writing. It's in reviewing. It's in going from 10 reports a year to 10 reports a month by managing AI outputs instead of producing from scratch. Human in the loop, not human as the loop.

Where does the human remain irreplaceable? Strategy. Institutional knowledge. Subject matter expertise. The person who's worked in epilepsy for 8 years knows what the KOLs think, what the payer is going to ask, and what good looks like before you even brief them. AI can't simulate that. Yet.

The HEOR team of the future is not one person per indication. It's one or two people running a full portfolio with a stack of AI agents behind them.

Start using the tools. Don't wait for your organization to certify them. Make yourself dangerous now.

Where are the biostats jobs in the Middle East?

An attendee asked a question I hadn't fielded before: why don't biostats jobs exist in the Middle East, and how do we change that?

The honest answer: jobs cluster at operational hubs. For pharma, those hubs are the US, UK, and parts of Europe. It's not that the talent doesn't exist in the Middle East — it's that the commercial infrastructure isn't there yet.

Near-term answer: target remote-first companies. Jazz operates this way. There are others. If you're the strongest candidate, geography doesn't have to be a disqualifier.

Medium-term: Saudi is becoming a serious commercial hub for ATMPs — gene therapy, cell therapy, rare disease, oncology. US reference pricing is accessible with the right launch sequence. The footprint is growing. Regional biostats and HEOR roles will follow.

It's slow. But it's moving.

HEOR in markets where the frameworks don't exist.

This was my favorite conversation of the session. A doctor joined from Malawi — doing his PhD on willingness to pay for monoclonal antibodies for malaria prevention across Kenya, Malawi, and Uganda.

He asked how to apply HEOR frameworks in a setting where those frameworks don't exist.

And I told him: they don't. So don't apply them.

In an LMIC context, you're not building a NICE dossier. There's no accepted cost-per-QALY threshold. You're starting at a much earlier question: here is the burden the disease places on your healthcare system today. Here is what this intervention prevents. Here is what it costs the system now versus what it costs with the intervention.

That's a budget impact model, not a cost-effectiveness analysis. And it's a conversation with a financial decision-maker, not a health technology committee.

The science is only as good as your ability to drive adoption. That's the lens.

What's next.

The next session is coming. I'll send the link — and this time it'll work.

If you have questions you want me to tackle, hit reply. If you want to be a future panelist, let me know what you're working on.

And if today's session made you think about something you haven't resolved yet — that's the point.

See you next time.

— Sanket

Sidebar with Sanket is a free monthly HEOR office hours. If someone forwarded this to you, sign up here.

— Sanket

P.S. Hit reply with the question you've never been able to ask anywhere else. I read every one.